From Avatars to Yugma: Exploring Technologies

American College of Clinical Pharmacy (ACCP)

Spring Forum Meeting 2008

From Avatars to Yugma: Exploring Electronic Technologies to Teach
Facilitators: Donna Huynh and Stuart T. Haines

The following is a summary of the discussions of the participants at the ACCP Spring Forum Meeting held in Phoenix, Arizona on Sunday, April 3, 2008. This information was generated from a series of BRAINSTORMING activities regarding the potential uses, advantages, and disadvantages of various electronic technologies that could be employed during the teaching and learning process. As a brainstorming activity, the potential uses, advantages, and disadvantages outlined below may not be complete, accurate, or appropriate. Moreover, concepts are not fully described and require the reader to draw his/her own conclusion or interpretations.

The facilitators are NOT advocating for the use of these technologies and it should be recognized that any new technology requires a substantial commitment on the part of the users (instructors and students) to learn how to use the technology in an appropriate manner. While these technologies clearly have some potential benefits and may enable some forms of instruction that might not otherwise be possible, the facilitators STRONGLY recommend that technology should only be used when other methods are less likely to help the students to achieve the intended outcomes. In other words, technology should only be used when it is believed to be the best way to accomplish the instructional objectives.

Individuals who participated in the ACCP Program are free to download and use this information for whatever purpose they desire ... but if used for a scholarly or commercial endeavor, appropriate recognition of the facilitators should be given.

Avatars and Virtual Stimulations

Potential Uses

• Orient students to a patient's room in a hospital or long-term facility
• Observe mediation errors/communications
• Simulate emergeny or "code" situations
• Physical assessment of abnormalities
• Ensuring students see all types of patients, disease states
• Interprofessional scenarios (e.g. pharmacist-physician, pharmacist-nurse)
• Anatomy/visual physiology
• Structure Activity Relationships (visualize drug/receptor bindings)
• Sim-pharmacy
• Patient counseling
• Ethics (making a decision and seeing the outcomes)
• Experiencing adverse drug interactions
• Demonstrating sterile technique
• Dealing with patients with communication barriers (e.g. non-English speaking, hearing impairments)
• Virtual hospital rounds

Advantages

Disadvantages

Able to stimulate rare situations Fun Great prequel to "real" experiences Practice whenever they want (and as many times they want) Resource sparing (no need to pay for actors) Real time quizzing with formative feedback Active learning Good for visual learners Can develop scenarios based on student responses (layering) Standardized assessment Modeling of communication skills Simulated labs for basic science courses Self-learning Less inhibition to interact

Not "real" enough (not hands on, may not take it seriously) Difficult to cover all possible scenarios Access to internet Different learning styles Social isolation May not work well for students with limited technology or physical disabilities Decrease critical thinking Assessment of student use Have to follow a predefined path Older students may not relate to technology Too much like a game Doesn't work well for information that is constantly changing Requires students to be self-learners

Blogs

Potential Uses

• Developing a virtual journal club (students responsible for reviewing / critiquing assigned journals and posting summaries)
• Developing disease specific webpage
• Writing reflective journal entries for introductory or advanced practice experiences
• Reporting about student organization activities (upcoming or past events)
• Highlighting Lecture reflections (e.g. Most important points by the instructor)
• Debate controversial issues

Wikis and/or Google Docs

Potential Uses

• Writing SOAP notes or care plans as a group assignment
• Responding to drug information requestions / writing drug information papers
• Group work examing case studies - one group develops the cases ...and another group "solves" the case
• Developing a peripheral "brain" or study guide - an approved "cheat sheet" that all students are allowed to use for an exam OR on clinical rotations
• Facilitating small group or committee work
• Scheduling / coordinating group work (Google Docs ... Spreadsheets)
• Facilitate faculty collaboration on developing cases or other course materials
• Student presentations (Google Docs ... Powerpoint)
• Patient information leaflets
• Drug information monographs
• Setting up a budget for a community pharmacy (Google Docs .... Spreadsheet function)
• Developing policies and procedures for organization or business
• Developing a curriculum vitae or resume
• Writing a scientific abstract or poster
• Creating and facilitating the activities of interprofessional working teams

Blogs, Wikis, and Google Docs

Advantages

Disadvantages

Holds every one accountable for doing their share of the work ... you can track participation You don't have to sign into a secondary academic site Tools are available for free ... and readily available on the web No additional software is required Using these tools is pretty intuitive ... shallow learning curve Enables group work over distance (anywhere in world with Internet access) and time (24/7) Faculty can make comments/give feedback to students during the development process Can see peer review comments made by students to one another Information (student work) is unlikely to be lost ... stored on servers with MULTIPLE redundances Shy students who might not contribute to face-to-face collaborations might contribute more in this environment Reduces the need for paper (good for the environment!) Reduces the need to e-mail assignments back and forth between collaborators All collaborators can access the SAME document at any time

Social interactions / team work processes are different online; skill set that is needed for face-to-face collaborations won't be developed Feedback is not as immediate as face-to-face communications Open access/security/privacy issues (information is stored on distant server) Blogger, Wiki, or Google Doc Sites may be blocked at some universities Plagiarism issues (temptations may be greater; may be more difficult to police) Written assignments (regardless of whether this technology is used) require more instructor's time to review and provide feedback Do not facilitate the development of oral communication skills Student may feel uncomfortable / inhibited knowing they are being monitored during the process Students may make inappropriate comments (harder to manage inappropriate communications in on-line environment) If work is used by other students (e.g. peripheral brain), information may not be accurate

Discussion Boards

Potential Uses

• Creating a drug information discussion board and letting students from different practice sites answer them
• Discuss patient cases among several groups
• Post FAQs and other course mechanics (e.g. virtual office hours, daily updates)
• Ethics debates
• Journal club
• Reflection activities (student answer a question from reading and have other students respond)
• Stimulated patient interview (give minimal information related to a patient case and students need to post questions to ask patient)
• Preparation for job/residency interviews
• Cross campus student interactions on assignments
• Discussion of group projects
• Facilitate communication with students after they leave practice site
• Problem based learning
• Student moderating "online" discussion (e.g., post student's questions and let students answer them)

Advantages

Disadvantages

Accessibility of information Allow students to respond that otherwise wouldn't in the classroom Time management Serves different learning styles Decrease number of emails Allow time for student to think about answers Secure because of limited access Familiar technology Can post links Develop writing skills Promote teamwork

Access to resources may be an issue Copying/plagiarizing is easier to do Reduce face to face conversations (lack of personal interactions) May not serve those who learn in person Lots of time to monitor for students and instructors Uncomfortable with creating new threads instead of responding Difficult to read long posts online More difficult to search Misinterpretation of written communication Lurkers can hind Cultural issues in the way we express things Need many small groups Not real time (no sense of urgency), loss of acuity Loss of professionalism Requires (sometimes elaborate) ground rules to guide participation

Digital Portfolios

Potential Uses

• Collection of useful documents (and multimedia?) to support employment or residency applications
• Student Portfolios - track assignments completed during a specific experiential rotation or during entire series of advanced practice rotations
• Facilitate communication between students and their mentors and/or advisors throughout the learning process
• Repository of faculty-student evaluations for the entire course of student's learning experiences in school
• Residency portfolios
• Tenure and promotion portfolios for faculty
• Accreditation documents for schools and universities

Advantages	Disadvantages
Central repository easily accessible to the student, faculty, preceptors, and mentors Environmentally friendly? (cut down on paper) Less bulky (stored electronically) Easily to search and reorganize	Potential legal issues / privacy concerns Overwhelming amount of information Engender apathy / limited creativity (only cut and paste existing documents)

Online Conferencing

Potential Uses

• Student presentations / faculty lectures
• Communicate with students at distant sites / at home / from a remote location (e.g. while attending a conference)
• Development activities for preceptors
• Enables committee / faculty interactions at distant sites / from a remote location
• Lead small group discussions
• Lead discussions with students at remote practice locations (e.g. during APPEs)
• Office hours for faculty
• Online exam review sessions (pre-exam or post-exam debriefing)
• Mentoring meeting with students, faculty, mentoring when you can't meet face-to-face

Advantages

Disadvantages

Enable invited (national / international) experts to teach a class from a remote location Participants can be located anywhere (in the state, country, or world) .... as long as they have Internet access Allows participants to review material repeated Cheaper than traveling to remote locations Reduces travel time Job satisfaction ... you can work from home! Can reuse lecture that don't need updating Eliminate excuses why students weren't able to attend class No (smaller) physical space requirements .... don't need to build new classrooms or conference rooms

Must all be online at the same time (synchronous) [Facilitator note: sessions can be recorded and accessed later] Participants can easily get distracted by other things in their environment (unlike classroom environment) Interaction is not a rich as face-to-face interactions Managing "classroom" environment is difficult - need to use new tools / methods to acknowledge and respond to students Can't determine if the participants are paying attention Disengages some participants (similar to teleconferences) Connection speed ... requires high speed connect for video/audio to work well May be more difficult to follow speaker, slides, and student chat ... all at the same time Miss the subtle voice inflections or body language of the speaker